Mapping health and its social determinants across 31 European countries in 2024

Abstract Background Research on health inequalities has established clear links between the social environment and health, highlighting the myriad of social conditions that influence health. Still, empirical studies remain fragmented, often focusing on individual pathways of health or isolated determinants. This study applies the framework by the WHO Commission on Social Determinants of Health to quantify and map the multiple social determinants contributing to health inequalities across Europe. Methods We use data from the European Social Survey round 11, representative of all population aged 15 and over in 31 countries. We draw from from the Health Inequalities rotating module and the core questionnaire to cover a wide arrange of determinants. A total of 37 variables are grouped into seven dimensions in line with the WHO framework: material, behavioural, occupational, educational, psychosocial, sociality, and healthcare related determinants. For each domain, we construct national-level “risk scores” by aggregating disadvantage indictors and standardize them using Z-scores to facilitate cross-country comparisons. Results are presented through maps to ease interpretation. Results Results show variability in the distribution of health determinants across Europe. Educational and Material risks are the highest in the South. Sociality risk also seems higher in Southern and Central/Eastern Europe. Behavioural, Psychosocial, and Healthcare-related access are equally distributed across Europe. Occupational determinants present a lot of variability between countries with no clear regional pattern. Conclusions Empirical data shows us that social determinants of health are not equally distributed across Europe, and that the burden of these risks mostly falls in Southern countries. Key messages • Social determinants are unevenly distributed across Europe, highlighting the need for targeted policies and cross-country comparative research. • Complex theoretical frameworks on health inequalities can be can be successfully operationalized and applied to empirical data to uncover patterns across countries.